2 Please submit the following documents along with the application for attestation/ Power of Attorney (in person or by mail): Filled in application form for attestation/Power of Attorney (Form C), 1 (one) copy Fees for each document, $ (REGULAR 2-5 days), $ (URGENT one day), in the form of money order/cashier check payable to EMBASSY of BANGLADESH . Cash or personal check is not accepted. Original Document and photocopy of the original document Proof of property ownership (Copy of mutation, succession/deed- RS, CS & BS) 2 (two) photographs of principals and 2 (two) photographs of the attorney are to be attached for verification by the EMBASSY .

3 Photographs (both principal and attorney) must be passport size, colour with white background, taken recently within the last six months. Photocopies of the valid/expired BANGLADESH Passport (1 7 pages), Any US photo ID such as Drivers License. Copy of court order in case of name change. Page-1 Info on Endorsements and Attestations Applicants for endorsements attestation of academic certificates, marriage or divorce certificate, statement of date of birth, certificate for transfer of dead body, alive certificate, driving license, renewal of driving license, transfer of residency certificate / power of attorney PLEASE KEEP A PHOTOCOPY OF YOUR DOCUMENTS IN A SAFE PLACE before submitting to the Consular Wing of the BANGLADESHEMBASSY .

4 Please read the instruction thoroughly from top to bottom. Requirement: Please submit the following documents along with the application for attestation / Power of Attorney (in person or by mail): 1. Filled in application form for attestation/Power of Attorney (Form C), 1 (one) copy 2. Fees for each document, $ (REGULAR 2-5 days), $ (URGENT one day), in the form of money order/cashier check payable to EMBASSY of BANGLADESH . Cash or personal check is not accepted. 3. Original Document and photocopy of the original document 4. Proof of property ownership (Copy of mutation, succession/deed- RS, CS & BS) 5.

5 2 (two) photographs of principals and 2 (two) photographs of the attorney are to be attached for verification by the EMBASSY . Photographs (both principal and attorney) must be passport size, colour with white background, taken recently within the last six months. 6. Photocopies of the valid / expired hand-written BANGLADESH Passport (1 7 pages) OR Machine Readable Passport (1-3 pages) 7. Any US photo ID such as Drivers License. 8. Copy of court order in case of name change. Procedures for obtaining Attestation of Documents / Power of Attorney from BANGLADESHEMBASSY , Washington DC.

6 Appear in Person: Power of Attorney or Attestation of any document such as a power of attorney (relating to sale/purchase of land in BANGLADESH , transfer/purchase/sale of shares, withdrawal of money/ pension from bank, etc) executed (signed) by any expatriate Bangladeshi national (in favor of a relative or a friend residing in BANGLADESH ), the executants is required to Appear In Person before the Consular Officer at the BANGLADESHEMBASSY in Washington DC to put signature in front of the officer. For multiple signatories of a document, the same rule applies for all, all signatories are required to appear in person at the EMBASSY to put signature.

7 Unable to appear in person: If the executants(s) /signatory(is) of a power of attorney is/are unable to appear in person the following three steps have to be followed with regard to the submission of the document to get it attested by this EMBASSY : First Step: Notarization by a Notary Public; Second Step: Authentication of Commission of the Notary Public by the Office of the Secretary of the State of the executants local state. To know the procedure of getting attestation from Individual State's Office, the applicant may contact respective State Government.

8 Third Step: Authentication by the US Department of State When the documents are mailed to the US Department of State, the applicant is required to send the papers needed by the EMBASSY of BANGLADESH (Duly filled in forms, money order and return postage) and provide an envelope addressed to BANGLADESHEMBASSY . The applicant may write a note so that once the US Department of State completes its attestation; they can mail the document to BANGLADESHEMBASSY . (For details on the procedure for authentication, please visit the web site of the US Page-2 Department of State.)

9 The authentication Department of the US Department of State is located at 518 23rd Street NW, State Annex-1 Columbia Plaza, Washington DC 20520, Phone: 202-647-5002). IMPORTANT INFORMATION AND GUIDELINES a. BANGLADESH Mission may endorse a document authenticated by Authentication Department of the US Department of State (Please see below for details). b. Documents issued from BANGLADESH have to be attested first by the Consular Section of the Ministry of Foreign Affairs, Dhaka, BANGLADESH , before it can be attested / endorsed by the Mission. Please Note: Consular endorsement with signature of the Consular Officer shall be affixed at the page of the document against the signature of the US Notary/Authentication Officer of the US Department of the State.

10 However, Mission s round seal shall be affixed on each page of the document provided they bear the emboss or endorsement of the US Notary. BANGLADESH Documents: For attestation, any document originating in BANGLADESH (like marriage certificate, birth certificate, police clearance, etc.) must contain the attestation of the Consular Section of the Ministry of Foreign Affairs, Dhaka. US Documents: Likewise, any document originating in the USA (certificate of incorporation, tax return, etc.) must have the authentication by the US Department of State. For such authentication, please visit the website of the US Department of State.

APPLICATION INSTRUCTIONS AND BACKGROUND ON THE OFFICE OF NOTARY PUBLIC APPLICATION INSTRUCTIONS Following is a play-script that describes the process and provides instructions for applying and obtaining

To be completed by the Attending Physician (The patient is responsible for the completion of this form without expense to the Company)Was patient hospitalized for this condition? Yes No If "Yes," Date(s) admitted: Date(s) discharged: